Warley Eduardo, Tamayo Antabak Natalia, Desse Javier, De Luca Adriana, Warley Fernando, Fernández Galimberti Guillermo, D'Agostino Graciela, Quintas Luis, Szyld Edgardo
Unidad de Infectología, Hospital Dr. Diego Paroissien, Buenos Aires, Argentina.
Medicina (B Aires). 2010;70(1):49-52.
In order to evaluate the incidence rate and possible risk factors associated with AIDS-related malignancies and infections (ARMI) we performed data analysis of clinical charts of HIV patients in two hospital cohorts, that started high activity antiretroviral therapy (HAART) between July 2003 and October 2007. Trimethoprim-sulfamethoxazole and Azithromycin prophylaxis was provided according to current guidelines. We evaluated development of ARMI six months after-starting HAART and its association with clinical and epidemiological variables. Of 235 patients analyzed -118 women (50.2%) and 117 men (49.8%)- 11 presented ARMI: 3 pulmonary TB and 3 lymph nodes TB cases, 3 cases with meningeal Cryptococcus, one Chagas's disease presenting brain mass and one with non-Hodgkin lymphoma. ARMI incidence: 4.7%. A CD4 cell count < 100/150 was associated with risk of developing ARMI. The mean CD4 cell count was 73 in patients who developed ARMI and 143 in those who did not. No association was found with the other analyzed variables. In the CD4 cell count < 150 group one out of 4 patients with reactive serology presented Chagas's disease causing brain mass; none of the 46 patients with reactive serology presented toxoplasmosis encephalitis. The incidence rate of ARMI was 4.7%. TB in first place and cryptococcosis in second were the AIDS events more frequently observed. A low CD4 cell count was the only observed risk factor statistically associated with development of ARMI. The role of prophylaxis in this population should be re-evaluated.
为了评估与艾滋病相关的恶性肿瘤和感染(ARMI)的发病率及可能的危险因素,我们对两个医院队列中于2003年7月至2007年10月开始接受高效抗逆转录病毒治疗(HAART)的HIV患者的临床病历进行了数据分析。根据现行指南提供了甲氧苄啶 - 磺胺甲恶唑和阿奇霉素预防用药。我们评估了开始HAART六个月后ARMI的发生情况及其与临床和流行病学变量的关联。在分析的235例患者中 - 118名女性(50.2%)和117名男性(49.8%) - 11例出现了ARMI:3例肺结核和3例淋巴结结核病例,3例脑膜隐球菌病,1例南美锥虫病出现脑肿块,1例非霍奇金淋巴瘤。ARMI发病率:4.7%。CD4细胞计数<100/150与发生ARMI的风险相关。发生ARMI的患者平均CD4细胞计数为73,未发生ARMI的患者平均CD4细胞计数为143。未发现与其他分析变量有关联。在CD4细胞计数<150的组中,4例血清学反应阳性的患者中有1例出现南美锥虫病导致脑肿块;46例血清学反应阳性的患者中无一例出现弓形虫脑炎。ARMI的发病率为4.7%。结核病位居首位,隐球菌病位居第二,是最常观察到的艾滋病相关事件。低CD4细胞计数是唯一观察到的与ARMI发生有统计学关联的危险因素。应重新评估该人群中预防用药的作用。